Actuarial Consultant

Focus Care Solutions is in search of a dynamic and experienced actuary to join our rapidly expanding team. The chosen candidate will play a pivotal role in analyzing diverse sets of patient health and claims data. This analysis will be instrumental in enabling our organization to comprehend, predict, and manage the risk associated with various value-based products, including MSSP, ACO REACH, and Medicare Advantage.

Key Responsibilities:

• Utilize strong knowledge and expertise in working with extensive Medicare claims datasets to conduct actuarial and risk adjustment (CMS-HCC) analysis.
• Make substantial contributions to project and client management initiatives.
• Employ advanced quantitative analysis skills rooted in epidemiology, biostatistics, econometrics, health informatics, or healthcare analytics to derive actionable insights.
• Proficiently utilize SQL, SAS, Python, or R for effective querying across multiple tables and subqueries.
• Demonstrate the ability to conduct nuanced analyses, produce unbiased results, and effectively communicate findings through data visualizations and reports.
• Apply expertise in descriptive and predictive analysis methods, including regression and classification techniques.
• Showcase proficiency in causal analysis, encompassing the design and execution of experimental and quasi-experimental studies.
• Possess deep familiarity with various healthcare data sources, including claims, electronic health records, event notification, clinical, and patient-reported data.
• Employ advanced data manipulation and mining skills, including expertise in SQL programming, and R or Python.
• Exhibit knowledge of standard methods for measuring healthcare utilization, spending, quality, outcomes, risk adjustment, provider profiling, and related analytical tasks.
• Communicate and present analytical findings effectively to stakeholders.
• Demonstrate excellent oral and written communication skills, conveying complex information in a clear and compelling manner.
• Thrive both independently and within a team environment, particularly in fast-paced settings where client satisfaction is paramount.

Preferred Qualifications:

• Possession of a Master’s Degree or higher in Mathematics, Statistics, Actuarial Science, or a closely related field.
• Experience with VRDC (CMS 100% Research Identifiable Files RIF) and/or LDS (5% Sample Data).
• Preferred experience in one or more of the following areas: Medicare Advantage, ACO, MSSP, Healthcare Economics, Pricing, Reserving, Forecasting, Data Analytics.
• Previous exposure to value-based care settings.
• Actuarial background is preferred but not mandatory.
• Proficiency in Excel, Word, and PowerPoint software.

If you are a highly motivated individual with a passion for leveraging data to drive impactful decisions in healthcare, we encourage you to apply for this exciting opportunity.

Job Type: Full-time

Pay: Up to $75,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience level:

• 2 years
• 3 years
• 4 years

Schedule:

• Monday to Friday

Experience:

• SQL: 1 year (Required)

Work Location: Remote